Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09768 | Date 18/08/2025 |
| Token No | SM/25-26/6495 18/08/2025 | Serial | 033 |
| Patient Name | Miss SABITA KUMARI KAMAT | Contact No | 9339333870 |
| Address | D1-103 SUBHASH NAGAR HOUSING COMPLEX PRAVASHNAGAR SERAMPORE 712249 | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||